Nanteza Angel, Gumikiriza-Onoria Joy, Santoro Anthony F, Karungi Christine, Ferraris Christopher M, Tsapalas Daphne, Kirsch Courtney, Nguyen Mina, Asiedu Nana, Tan Mei, Liu Jun, Dolezal Curtis, Musiime Victor, Dirajlal-Fargo Sahera, Robbins Reuben N
Butabika National Referral Mental Hospital, Kampala, Uganda.
Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda.
AIDS Behav. 2025 Mar;29(3):1004-1010. doi: 10.1007/s10461-024-04581-y. Epub 2024 Dec 30.
Suicide remains a global public health concern and is a leading cause of death among adolescents. Adolescents with perinatally-acquired HIV (PHIV) are particularly vulnerable to suicide and other challenges, including discrimination, stigma, educational difficulties, risk-taking behaviors, and medical complications. In Uganda, adolescents with PHIV experience a high burden of mental health problems, but there is scant information regarding suicide attempts. This study examined lifetime suicide attempts, depressive symptoms, and adverse experiences among adolescents with PHIV and demographically matched HIV-negative adolescents. One hundred Ugandan adolescents (12-20 years old), 50 with and 50 without PHIV, completed the Adverse Childhood Experiences (ACEs) questionnaire, Patient Health Questionnaire-A (PHQ-A), and the Adolescent Life Events Questionnaire (ALEQ), which included additional questions about suicide attempts. Independent t-test and chi-square analyses were used to compare scores between the two HIV status groups. There were no significant differences in sex across the HIV groups. The mean total scores of the full sample were ACEs M = 2.92 (SD = 2.49), ALEQ M = 10.61 (SD = 9.08) and PHQ-A M = 2.25 (SD = 3.55). The PHIV group had significantly higher PHQ-A (p < .001), ALEQ (p < .01), and ACEs (p < .001) scores than the HIV-negative group. Among adolescents with PHIV, 14% reported at least one previous suicide attempt, while none of the HIV-negative adolescents reported any attempt (X = 8.20, p = .02). Despite overall low depression scores, the PHIV group had significantly more depressive symptoms and were more likely to have suffered from psychosocial stressors.
自杀仍然是一个全球公共卫生问题，并且是青少年死亡的主要原因。围产期感染艾滋病毒（PHIV）的青少年尤其容易自杀以及面临其他挑战，包括歧视、污名化、教育困难、冒险行为和医疗并发症。在乌干达，感染PHIV的青少年承受着沉重的心理健康问题负担，但关于自杀未遂的信息却很少。本研究调查了感染PHIV的青少年以及在人口统计学上匹配的未感染艾滋病毒的青少年的终身自杀未遂情况、抑郁症状和不良经历。100名乌干达青少年（12至20岁），50名感染PHIV，50名未感染，完成了童年不良经历（ACEs）问卷、患者健康问卷-A（PHQ-A）和青少年生活事件问卷（ALEQ），其中包括关于自杀未遂的额外问题。采用独立样本t检验和卡方分析比较两个艾滋病毒感染状况组之间的得分。两组在性别上没有显著差异。整个样本的平均总分分别为：ACEs，M = 2.92（标准差 = 2.49）；ALEQ，M = 10.61（标准差 = 9.08）；PHQ-A，M = 2.25（标准差 = 3.55）。感染PHIV组的PHQ-A（p <.001）、ALEQ（p <.01）和ACEs（p <.001）得分显著高于未感染艾滋病毒组。在感染PHIV的青少年中，14%报告至少有过一次自杀未遂，而未感染艾滋病毒的青少年中无人报告有过自杀未遂（X = 8.20，p = 0.02）。尽管总体抑郁得分较低，但感染PHIV组有更多的抑郁症状，并且更有可能遭受过心理社会压力源的影响。
